OCTA定量分析糖尿病视网膜病变患者黄斑区微循环变化

目的:通过光学相干断层扫描血管成像(OCTA)技术,评估糖尿病视网膜病变(DR)患者黄斑区微循环变化,并对可能影响黄斑区微循环的危险因素进行分析,为DR早期筛查、诊断及治疗干预提供临床依据。方法:回顾性研究。收集2022-05/10于西安市中心医院眼科门诊及病房就诊的2型糖尿病患者75例75眼,分为无DR(NDR)组28眼、非增殖型DR(NPDR)组25眼、增殖型DR(PDR)组22眼。应用OCTA对黄斑区视网膜行3mm×3mm血流成像扫描,自动获得浅层视网膜黄斑中心凹区、黄斑旁中心凹区(1~3mm)以及黄斑区3mm×3mm的血管密度(VD)和黄斑中心凹无血管区(FAZ)面积,分析黄斑区各参数在不同程度DR患者中的变化。结果:与NDR组相比,PDR组和NPDR组患者黄斑区3mm×3mm浅层视网膜毛细血管(SCP)的VD降低(均P<0.017),并且黄斑旁中心凹VD在各象限均降低(P<0.017),以PDR组降低最为显著。PDR组和NPDR组患者FAZ面积明显大于NDR组(P<0.017)。DR患者的年龄、同型半胱氨酸、最佳矫正视力(LogMAR)、眼轴、糖化血红蛋白(HbA1c)与黄斑中心凹区VD呈负相关(P<0.05),同型半胱氨酸、最佳矫正视力(LogMAR)、眼轴、糖尿病病程与黄斑区3mm×3mm VD呈负相关(P<0.05),甘油三酯、最佳矫正视力(LogMAR)、HbA1c与黄斑旁中心凹区VD呈负相关(P<0.05),总胆固醇、CMT与VD无明显相关(P>0.05)。结论:OCTA可以监测到DR患者黄斑区微循环变化,DR患者的全身情况与黄斑区微循环密切相关。

Helicobacter pylori infection and esophageal cancer risk:An updated meta-analysis

AIM:To clarify the association between Helicobacter pylori(H.pylori)infection and the risk of esophageal carcinoma through a meta-analysis of published data.METHODS:Studies which reported the association between H.pylori infection and esophageal cancer published up to June 2013 were included.The odds ratios(ORs)and corresponding 95%CIs of H.pyloriinfection on esophageal cancer with respect to health control groups were evaluated.Data were extracted independently by two investigators and discrepancies were resolved by discussion with a third investigator.The statistical software,STATA(version 12.0),was applied to investigate heterogeneity among individual studies and to summarize the studies.A meta-analysis was performed using a fixed-effect or random-effect method,depending on the absence or presence of significant heterogeneity.RESULTS:No significant association between H.pylori infection and esophageal squamous cell carcinoma(ESCC)risk was found in the pooled overall population(OR=0.97,95%CI:0.76-1.24).However,significant associations between H.pylori infection and ESCC risk were found in Eastern subjects(OR=0.66,95%CI:0.43-0.89).Similarly,cytotoxin-associated gene-A(CagA)positive strains of infection may decrease the risk of ESCC in Eastern subjects(OR=0.77,95%CI:0.65-0.92),however,these associations were not statistically significant in Western subjects(OR=1.26,95%CI:0.97-1.63).For esophageal adenocarcinoma(EAC)the summary OR for H.pylori infection and CagA positive strains of infection were 0.59(95%CI:0.51-0.68)and 0.56(95%CI:0.45-0.70),respectively.CONCLUSION:H.pylori infection is associated with a decreased risk of ESCC in Eastern populations and a decreased risk of EAC in the overall population.

西安市同区域不同学段学生近视率差异及原因分析

目的:对西安市同一行政区域不同学段学生进行视力筛查,了解该区域不同学段学生近视率的差异,并进行原因分析。方法:采用随机抽样法,选取小学21所、初中和普通高中各3所及职业高中1所共28所学校13707人进行裸眼远视力和电脑屈光检测。结果:西安市同区域小学、初中、高中和职业高中近视检出率分别为32.27%、72.07%、81.22%、65.12%;总近视率为47.81%;各年级女生近视率均高于男生;小学和初中近视率随年级升高而升高;随着学段的升高,高度近视占比由小学的2.40%升高至高中的16.51%。结论:西安市同区域不同学段学生近视率具有差异性,随着学段的上升,近视率呈一定升高趋势;女生近视率高于男生;与2018年全国不同学段儿童青少年近视调查结果对比,2021年西安市同区域小学阶段近视率下降显著,初中及高中阶段近视率虽没有上升,但降幅不明显。

Intra-continental deformation and tectonic evolution of the West Junggar Orogenic Belt,Central Asia:Evidence from remote sensing and structural geological analyses

The West Junggar Orogenic Belt(WJOB)in northwestern Xinjiang,China,is located in the core of the western part of the Central Asian Orogenic Belt(CAOB).It has suffered two stage tectonic evolutions in Phanerozoic,before and after the ocean–continental conversion in Late Paleozoic.The later on intracontinental deformation,characterized by the development of the NE-trending West Junggar sinistral strike-slip fault system(WJFS)since Late Carboniferous and Early Permian,and the NW-trending Chingiz-Junggar dextral strike-slip fault(CJF)in Mesozoic and Cenozoic,has an important significance for the tectonic evolution of the WJOB and the CAOB.In this paper,we conduct geometric and kinematic analyses of the WJOB,based on field geological survey and structural interpretation of remote sensing image data.Using some piercing points such as truncated plutons and anticlines,an average magnitude of^73 km for the left-lateral strike-slip is calculated for the Darabut Fault,a major fault of the WJFS.Some partial of the displacement should be accommodated by strike-slip fault-related folds developed during the strike-slip faulting.Circular and curved faults,asymmetrical folds,and irregular contribution of ultramafic bodies,implies potential opposite vertical rotation of the Miao’ergou and the Akebasitao batholiths,resulted from the sinistral strike-slipping along the Darabut Fault.Due to conjugate shearing set of the sinistral WJFS and the dextral CJF since Early Mesozoic,superimposed folds formed with N–S convergence in southwestern part of the WJOB.

New timing of the Indosinian intracontinental deformation from the Triassic growth strata in the Kuqa Depression,Southern Tianshan,China

1.Objectives In the Indosinian duration,series of Gondwana-related plates pieced together and formed the geological sketch of China for the first time,i.e.the Yangtze,Sino Korean,Tarim plates,and other sub-plates that had been isolated for a long time.Subduction and collision among the Tarim,Qaidam,and Qiangtang blocks in Triassic,as well as the closure of the Paleo-Tethys Ocean,reactivated Late Paleozoic suture zones in the Tianshan orogen region(Hendrix MS et al.,1992).

New progress in understanding roles of nitric oxide during hepatic ischemia-reperfusion injury

Hepatic ischemia-reperfusion injury(HIRI)is a major clinical cause of morbidity and mortality in liver surgery and transplantation.Many studies have found that nitric oxide(NO)plays an important role in the HIRI and its increase or decrease can affect the progression and outcome of HIRI.However,the role of NO in HIRI is controversial and complicated.NO derived by endothelial NO synthase(eNOS)shows a protective role in HIRI,while excessive NO derived by inducible NO synthase(iNOS)accelerates inflammation and increases oxidative stress,further aggravating HIRI.Nevertheless,the overexpression of eNOS may exacerbate HIRI and iNOS-derived NO in some cases reduces HIRI.Here we review the new progress in the understanding of the roles of NO during HIRI:(1)NO possesses different roles in HIRI by increasing NO bioavailability,down-regulating leukotriene C4 synthase,inhibiting the activation of the nuclear factorκB(NFκB)pathway,enhancing cell autophagy,and reducing inflammatory cytokines and reactive oxygen species(ROS).And NO has both protective and deleterious effects by regulating apoptotic factors;(2)eNOS promotes NO production and suppresses its own overexpression,exerting a hepatoprotective effect reversely.Its activation is regulated by the PI3K/Akt and KLF2/AMPK pathways;and(3)iNOS derived NO mainly has deteriorating effects on HIRI,while it may have a protective function under some conditions.Their expression should reach a balance to reduce the adverse side and make NO protective in the treatment of HIRI.Thus,it can be inferred that NO modulating drugs may be a new direction in the treatment of HIRI or may be used as an adjunct to mitigate HIRI for the purpose of protecting the liver.

Solitary extramedullary plasmacytoma in retroperitoneum:A case report and review of the literature

Extramedullary plasmacytoma(EPM) is a plasma cell tumor arising outside of the bone marrow.Solitary EMP is an uncommon neoplasm and rarely occurs in the retroperitoneum and lacks distinctive clinical manifestations.We report a 26-year-old man with a solitary EMP in the retroperitoneum and discuss its clinical features,diagnosis and treatment.

Recent advances in research on natural product inhibitors of SREBPs

Sterol regulatory element-binding proteins(SREBPs)are a class of cholesterol-sensitive transcription factors that play important roles in lipid metabolism.Natural product inhibitors of SREBPs have been shown to inhibit the synthesis of free fatty acids and cholesterol,promote the burning of brown fat,and relieve insulin resistance by inhibiting different links during the synthesis,cleavage,and transport of SREBPs,thereby improving obesity,diabetes,atherosclerosis,and other metabolic diseases and disorders.There are numerous Chinese herbal medicines with verified efficacy in the treatment of metabolic diseases,including Coptis chinensis Franch.and Pueraria peduncularis Grah.for diabetes,Pueraria peduncularis Grah.,Epimedium brevicornum Maxim.,and Panax ginseng C.A.Meyer for osteoporosis,and Nelumbo nucifera Gaertn.and Poria cocos(Schw.)Wolf.for obesity.Present-day research on the mechanisms underlying the activity of traditional Chinese medicine has indicated that certain chemical components of these traditional preparations can be used to treat metabolic diseases by inhibiting SREBPs.Progress in the research on natural product SREBP inhibitors is continuing apace,and the mechanisms of action of certain small molecules have become well established.In this study,we review recent progress in the research on natural small-molecule inhibitors of SREBPs,including flavonoids,saponins,triterpenoids,and alkaloids,which we hope will provide a useful reference for future research and development of drugs for the treatment of metabolic diseases.

Mutagenesis of SlNAC4 by CRISPR/Cas9 alters gene expression and softening of ripening tomato fruit

Softening is one of the key fruit quality traits,which results from the selective expression of cell wall metabolism genes during ripening.The identification of transcription factors(TFs)that regulate fruit softening is an important field in order to understand and control fruit softening.In tomato,NAC(NAM,ATAF,and CUC)TFs members have been demonstrated to be involved in fruit ripening regulation,including NAC-NOR(nonripening),NOR-like1,SlNAC4,SlNAC1.Here,we generated slnac4 mutant knockout(CR-SlNAC4)tomato plant by a clustered regularly interspaced short palindromic repeats genomic targeting system(CRISPR/Cas9)and SlNAC4 overexpressing(OE-SlNAC4)plant.In addition to confirming the previously reported results that SlNAC4 positively regulates fruit ripening,we found that SlNAC4 has a strong effect on tomato fruit softening.Compared with the control fruit,fruit softening was inhibited in slnac4 fruit and conversely was accelerated in OE-SlNAC4 tomato fruit.Through RNA-sequencing(RNA-seq)analysis,we found that expression levels of SlEXP1(expansin)and SlCEL2(endo-β-1,4 glucanase)genes involved in cell wall metabolism were significantly different in WT(wild type)/slnac4 and WT/OE-SlNAC4 fruit.Further study showed that these genes contained a NAC TF binding domain in their promoter regions.In vitro electrophoretic mobility shift assays(EMSA)and dual-luciferase reporter assays(DLR)demonstrated that these two genes were the direct targets of SlNAC4 binding and transactivation.The results enriched the function of SlNAC4 and provided a new dimension in understanding the regulation of tomato fruit softening.

Perinatal prevalence of birth defects in the Mainland of China,2000–2021:a systematic review and meta-analysis

Background Although birth defects are of great concern globally,the latest national prevalence has not yet been quantified in China.We conducted a systematic review and meta-analysis to estimate the perinatal prevalence of birth defects in the Mainland of China between 2000 and 2021.Methods We performed a systematic literature search of six databases for relevant articles published between January 1,2000,and March 1,2023.We included published studies that reported data on the perinatal prevalence of birth defects in the Mainland of China.The DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and its 95%confidence interval(CI).We also conducted subgroup analyses and univariable meta-regressions to explore differences in prevalence by time period,geographic region,and other characteristics.Results We included 254 studies reporting the perinatal prevalence of birth defects and 86 studies reporting only the prevalence of specific types of birth defects.Based on 254 studies covering 74,307,037 perinatal births and 985,115 cases with birth defects,the pooled perinatal prevalence of birth defects was 122.54(95%CI 116.20–128.89)per 10,000 perinatal births in the Mainland of China during 2000–2021.Overall,the perinatal prevalence of birth defects increased from 95.60(86.51–104.69)per 10,000 in 2000–2004 to 208.94(175.67–242.22)per 10,000 in 2020–2021.There were also significant disparities among different geographical regions.Congenital heart defects(33.35 per 10,000),clefts of the lip and/or palate(13.52 per 10,000),polydactyly(12.82 per 10,000),neural tube defects(12.82 per 10,000),and inborn errors of metabolism(11.41 per 10,000)were the five most common types of birth defects.The perinatal prevalence among males was significantly higher than that among females(β=2.44×10^(−3),P=0.003);a higher perinatal prevalence of birth defects was observed among perinatal births whose mothers were≥35 years(β=4.34×10^(−3),P<0.001).Conclusion Comprehensive and sustained efforts are needed to strengthen surveillance and detection of birth defects,improve prenatal and postnatal healthcare,and promote rehabilitation,especially in underdeveloped areas.

Simulation of filling construction of permeable geosynthetic tubes

The filling construction of permeable geosynthetic tubes is considered.First,an analytical approach is developed to determine the internal pressure,tension and shape of the cross section of a geosynthetic tube based on its volume.An analytical solution for the drainage rate of the tube is then derived.The course of the filling construction is divided into several time intervals and the volume of the tube after each interval is obtained from the equilibrium of flow calculated from the drainage rate and filling rate.The validity of our analytical approach is tested by comparing our results with previously published experimental result.The results of this comparison indicate that our method is applicable for simulating the filling construction of permeable geosynthetic tubes.

Seroepidemiology of Syphilis Infection among 2 Million Reproductive-age Women in Rural China：A Population-based, Cross-sectional Study

Background：Quantifying syphilis prevalence is important for planning interventions and advocating for resources on syphilis.However,data on large sample studies regarding the prevalence of syphilis among reproductive-age women in rural China were not available for analysis.The aim of the study was to determine the prevalence,epidemiological characteristics,and related factors of syphilis infection among reproductive-age women in rural China.Methods：Data were obtained from a nationwide,population-based,cross-sectional study under the National Free Preconception Health Examination Project which covered all the 31 provinces in China's Mainland.Women intending to get pregnant within the next 6 months were enrolled between January 1,2010,and December 31,2012.Sociodemographic,gynecological and obstetric characteristics,and other relevant information were obtained through face-to-face interviews.Treponema pallidum particle agglutination assay test was used to detect positive samples of syphilis.Univariate and multivariate logistic regressions were performed to assess the associations between syphilis seropositivity and related factors.Results：The overall seroprevalence of syphilis （SPS） among the 2,044,126 women who received syphilis screening test during 2010-2012 was 0.37% （95% confidence interval [CI]：0.36-0.37%）.The SPS appeared 0.24% （95% CI：0.23-0.26%） and 0.66% （95% CI：0.59-0.72%） in women at 21-24 and 40-44 years of age,respectively,showing an increase of SPS,parallel with age,and the difference was significant.SPS was significantly higher in ethnic minorities than that in Han nationality （0.58% vs.0.35%,respectively,odds ratio [OR] =1.41,95% CI：1.30-1.53） and higher in workers than that in farmers （0.45% vs.0.36%,respectively,OR =1.27,95% CI：1.14-1.41）.Women with primary school or below level had a higher SPS as compared to those with college or above educational level （0.61% vs.0.32%,respectively,OR =2.49,95% CI：2.14-2.89）,and the increase reversely correlated with the levels of education.Women whose spouses were syphilis seropositive had significant greater risk （OR =48.26,95% CI：44.38-52.48） as compared those whose spouses were seronegative.Women who reported having had a history of sexually transmitted infections were more likely to be tested positive for serological syphilis （OR =27.17,95% CI：20.44-36.11） as compared to those without.Conclusions：High SPS is seen among reproductive-age women in rural China that calls for targeted interventions on syphilis prevention and control in this target population,with emphasis on those who are 35 years of age and above,less educated,being minor ethnicity,workers,and living in the western regions of China.

Theoretical elastoplastic analysis for foundations with geosynthetic-encased columns

As a new technique in ground improvement, geosynthetic-encased columns (GECs) have promising applications in soft soil foundation. By assuming yielding occurs in the columns while the surrounding soil and the geosynthetic remain elastic, an elastoplastic analytical procedure for foundations improved by GECs is proposed. The radial stresses that the geosynthetic provides and the elastoplastic deformations of the foundation resting on a rigid base are derived. A comparison with finite element analysis shows that the proposed method is effective and can provide a reasonable prediction of a GEC's deformation. Subsequent parametric analysis indicates that higher geosynthetic stiffness leads to better performance of the composite foundation. The optimum length of encasement is related to the load acting on the foundation and the permissible vertical and radial displacements of the column. Moreover, as the dilation angle of the column increases, the settlement decreases, especially under high loading. The influence of the encasement is more significant in soils with smaller elastic modulus.

Methylenetetrahydrofolate reductase C677T polymorphism predicts response and time to progression to gemcitabine-based chemotherapy for advanced non-small cell lung cancer in a Chinese Han population

Objective： The aim of this study was to evaluate the association between the methylenetetrahydrofolate reductase （MTHFR） C677T excision repair cross-complementation group 1 （ERCC1） genetic polymorphisms and the clinical efficacy of gemcitabine-based chemotherapy in advanced non-small cell lung cancer （NSCLC）. Methods： A total of 135 chemonaive patients with unresectable advanced NSCLC were treated with gemcitabine/platinum regi- mens. The polymorphisms of MTHFR C677T, ERCC1 C8092A, and ERCC1 Cl18T were genotyped using the TaqMan methods. Results： The overall response rate was 28.9%. Patients with MTHFR CC genotype had a higher rate of objective response than patients with variant genotype （TT or CT） （41.2% versus 19.1%, P=0.01 ）. Median time to progression （TTP） of patients with MTHFR CC genotype was longer than that of patients with variant genotype （7.6 months versus 5.0 months, P=0.003）. No significant associations were obtained between ERCC1 C118T and C8092A polymorphisms and both response and survival. Conclusions： Our data suggest the value of MTHFR C677T polymorphism as a possible predictive marker of response and TTP in advanced NSCLC patients treated with gemcitabine/platinum.

Neuroendocrine-Immune Regulating Mechanisms for the Anti-Inflammatory and Analgesic Actions of Acupuncture

Pain and inflammatory diseases are important clinical indications of acupuncture,which have been widely accepted in the international community.Previous studies have been focusing on rapid analgesia of acupuncture through the regulation of nervous system,but few studies on the inflammation regulatory mechanisms in which acupuncture inhibits the peripheral sensitization-induced pain.Based on studies concerning acupoint mechanisms of acupuncture actions and related researches on acupuncture regulating neuroendocrine and immune systems,we put forward the scientific hypothesis that acupuncture regulates neuroendocrine-immune(NEI)network and key response media therein,so as to achieve anti-inflammatory and analgesic effects in target organs.We have established a platform for acupuncture at ST36 to alleviate inflammatory pain in adjuvant induced arthritic rats.Based on the complex network analysis of multi-dimensional data from multi-time point and multi-site detection of NEI common signaling molecules,we have clarified the regulatory effects of acupuncture on NEI network and corresponding downstream immune network.Results indicated that monocytes/macrophages are the key targeting cells of acupuncture regulation,and acupuncture may display the anti-inflammatory and analgesic effects by regulating polarization of T cells in lymph nodes and polarization of M1/M2 macrophages in inflamed joints/paws.In addition,we have spotted a key molecule for acupuncture analgesia,CXCL1,as well as clarified the novel central analgesic mechanism of acupuncture mediated by CXCL1/CXCR2 desensitization.Thereby,we have provided novel evidence of the anti-inflammatory and analgesic actions of acupuncture through regulating NEI network and several key substances,highlighting a systemic research paradigm for investigating mechanisms of acupuncture actions.